Critical illness polyneuropathy and myopathy

Q:  Critical illness myopathy (CIM) and critical illness polyneuropathy (CIP) include all of the following except? 

A) Symmetric limb weaknesses
B) Ventilatory muscle weakness
C) Extraocular muscles spared
D) Reduced tendon reflexes
E)  Distal muscles more affected 


Answer: E

CIM and CIP affect a large population of critically ill patients who stay more than 2 weeks in ICU. Symptoms are usually overlapped. All of the above choices are correct except E.  The most dreaded clinical feature is flaccid quadriparesis where proximal muscles are more affected than distal muscles. Early mobilization and physical therapy, avoiding prolonged exposure to steroids and neuro-muscular blockers are considered key interventions.

#earlymobilization
#neurology



Reference:

Latronico N, Bolton CF. Critical illness polyneuropathy and myopathy: a major cause of muscle weakness and paralysis. Lancet Neurol 2011; 10:931.